1. Technical Field
This document relates to methods and materials for reducing development of stenosis of arteriovenous fistulas. For example, this document relates to reducing IEX-1 polypeptide expression or activity within a mammal to reduce development of stenosis of arteriovenous fistulas.
2. Background Information
There are more than 1,500,000 patients worldwide with end stage renal disease (ESRD). These patients require hemodialysis for removal of uremic toxins and control of volume. In order for effective hemodialysis to be performed, an optimally functioning hemodialysis vascular access is needed. An arteriovenous fistula (AVF) is the preferred vascular access for chronic hemodialysis because it has lower infection and thrombosis rates with increased patency when compared to polytetrafluoroethylene (PTFE) grafts (Roy-Chaudhury et al., J. Am. Soc. Nephrol., 17:1112-1127 (2006) and Riella and Roy-Chaudhury, Nat. Rev. Nephrol., 9:348-357 (2013)). AVF stenosis occurs at the outflow vein due to venous neointimal hyperplasia (VNH) with the one-year patency of AVFs being approximately 60% (Al-Jaishi et al., Am. J. Kidney Dis., 63:464-478 (2014)). The stenosis requires frequent radiological and surgical intervention to prolong AVF function resulting in increased economic and health burden (Riella and Roy-Chaudhury, Nat. Rev. Nephrol., 9:348-357 (2013) and Rooijens et al., Eur. J. Vasc. Endovasc. Surg., 28:583-589 (2004)).